European Psychiatry - Volume 33 - March 2016

135 / 812

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S131
Conclusions More research in this field is warranted.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW44
Hypomanic symptoms in mixed
depression – is DSM-5 wrong?
Evidence from the BRIDGE-II-MIX
study
D. Popovic ∗ orrent ieta . Azorin ngst
S. Mosolov , C.L. Bowden , A. Young
1 Unviersity Of Barcelona, Idibaps, Hospital Clinic, Psychiatry,
Barcelona, Spain
2 Hôpital Sainte-Marguerite, Psychiatry, Marseille, France
3 Psychiatric Hospital, University of Zurich, Psychiatry, Zurich,
Switzerland
4 Moscow Research Institute of Psychiatry, Psychiatry, Moscow,
Russia
5 University of Texas Health Science Center, Psychiatry, USA
6 King’s College, Psychiatry, London, United Kingdom
∗ Corresponding author.
Introduction DSM-5 criteria for the mixed features specifier
exclude symptoms, such as psychomotor agitation, irritability and
mood lability.
Objectives The goal of the BRIDGE-MIX study was to provide
an estimate of the frequency of mixed states (MXS) in depressed
patients according to different definitions and to compare their
clinical validity.
Aims The aim of this sub-analysis is to examine the importance
of distinct hypomanic symptoms in mixed depression, including
those excluded from DSM-5.
Methods A total of 2811 subjects were enrolled in this
multicentric cross-sectional study. Psychiatric symptoms, socio-
demographic and clinical variables representing risk factors for
bipolar disorder (BD) were collected. Multiple comparisons anal-
ysis was performed using a Bonferroni-corrected threshold and
stepwise-backward logistic regression.
Results Two hundred and twelve patients fulfilled DSM-5 criteria
for MXS. The most common symptoms in this subset and in the
total sample are shown in Table 1 (Tables are not available for this
abstract). Logistic regression demonstrated specific associations of
psychomotor agitation (Wald 5.092, P = 0.024), impulsivity (Wald
28.47, P < 0.0001), racing thoughts (Wald 12.657, P < 0.0001) and
logorrhoea/pressured speech(Wald 230.720, P < 0.0001) with DSM-
5 diagnosis of MXS (Table 2).
Conclusions The DSM-5 definition ofMXS excludes “overlapping”
mood criteria, such as psychomotor agitation, irritability and mood
lability, among the most frequent features of mixed depression in
our sample and in literature. The results of this study highlight
the impact of the excluded symptoms on MXS diagnosis. Although
these symptoms may be non-specific, their exclusion from DSM-5
may not be justified, in the absence of evidence that the remaining
criteria are sufficiently sensitive to identify MXS.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW45
Towards a redefinition of dissociative
spectrum dimensions inside Capgras
and misidentification syndromes in
bipolar disorder: Case series and
literature review
M. Preve ∗ alvatore Mula avaretto Godio
R. Traber . Colombo
1 Sociopsychiatric Organization, Psychiatric Clinic, Mendrisio,
Switzerland
2 McLean Hospital, Department of Psychiatry, Harvard Medical
School, Boston, USA
3 Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St.
George’s University Hospitals NHS Foundation Trust, London, United
Kingdom
4 Krankenhaus Brixen, Zentrum für Psychische Gesundheit, Brixen,
Italy
∗ Corresponding author.
Introduction Misidentification phenomena and Capgras Syn-
drome (CS) occur in different psychiatric (psychotic or major
affective illnesses) and neurological (traumatic brain injury,
epilepsy, neurosyphilis, etc.) disorders he aim of this report
is to redefine dissociative spectrum dimensions inside CS and
misidentification syndromes in patientswith Bipolar Disorder (BD).
Method Five inpatientswere assessedwith the SCID-P, SCID-DER,
DSS, HRSD, YMRS, a neurological and general medicine review, a
first-level brain imaging examination (CT and/or MRI). We con-
ducted a systematic literature review (PubMed, Embase, PsychInfo)
using the key terms “Capgras Syndrome” and “Misidentificaition”.
Results All patients were diagnosed with type-I BD and had con-
comitant CS that presented with misidentification phenomena in
the context of psychotic mixed state. They reported high scores for
autopsychic and affective depersonalization symptoms as well as
high SCI-DER (mean = 24.4) and DSS (mean = 13) total scores.
Discussion and conclusion To our knowledge in literature, there
are not studies that evaluated dissociative spectrum symptoms in
CS in BD. This condition of identity and self fragmentation could
be the key to shedding light on the interconnection between affec-
tive and non-affective psychotic disorders from schizophrenia to
BD, and may underscore the possible validity of the concept of the
unitary psychosis proposed by Griesinger urther research
is warranted to replicate our clinical and qualitative observations
and, in general, quantitative studies in large samples followed up
over time are needed. Methodological limitations are considered.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
References
[1] Fishbain DA, 1987.
[2] Salvatore P et al., 2014.
[3] Griesinger W, 1892.
[4] Reininghaus U et al., 2013.
[5] Kumbier E et al., 2010.
EW46
Mapping vulnerability to bipolar
disorders
M.R. Raposo ∗, M.D. Piqueras , I. Martínez , A.L. Galdámez ,
A. Gil , J.B. Murcia , A. Belmar , A. Rodríguez , P. Manzur ,
I. Bello , S. Bravo , V. Ivanov , C.J. García
1 Servicio Murciano de Salud, Centro de Salud Mental, Hospital
Universitario Santa Lucía, Cartagena, Murica, Spain
2 Servicio Murciano de Salud, Hospital Universitario Santa Lucía,
Cartagena, Murcia, Spain
3 Servicio Murciano de Salud, Residencia Psicogeriátrica Virgen del
Valle, El Palmar, Murcia, Spain
4 Servicio Murciano de Salud, Centro de Salud Mental Cartagena,
Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain
5 Servicio Murciano de Salud, Unidad Regional de Media Estancia,
Hospital Psiquiátrico Román Alberca, Murcia, Spain
6 Servicio Murciano de Salud, Centro de Salud Mental Cartagena,
Cartagena, Murcia, Spain
∗ Corresponding author.